title: Identification of dengue fever cases in Houston, Texas, with evidence of autochthonous transmission between 2003 and 2005.
abstract: Houston, Texas, maintains an environment conducive to dengue virus (DENV) emergence; however, surveillance is passive and diagnostic testing is not readily available. To determine if DENV is present in the area, we tested 3768 clinical specimens (2138 cerebrospinal fluid [CSF] and 1630 serum) collected from patients with suspected mosquito-borne viral disease between 2003 and 2005. We identified 47 immunoglobulin M (IgM)-positive dengue cases, including two cases that were positive for viral RNA in serum for dengue serotype 2. The majority of cases did not report any history of travel outside the Houston area prior to symptom onset. The epidemic curve suggests an outbreak occurred in 2003 with continued low-level transmission in 2004 and 2005. Chart abstractions were completed for 42 of the 47 cases; 57% were diagnosed with meningitis and/or encephalitis, and 43% met the case definition for dengue fever. Two of the 47 cases were fatal, including one with illness compatible with dengue shock syndrome. Our results support local transmission of DENV during the study period. These findings heighten the need for dengue surveillance in the southern United States.
authors.affiliation: 1 Baylor College of Medicine, Department of Pediatrics, Section of Tropical Medicine, National School of Tropical Medicine , Houston, Texas.
authors.forename: Kristy O
authors.initials: KO
authors.lastname: Murray
authors.forename: Liliana F
authors.initials: LF
authors.lastname: Rodriguez
authors.forename: Emily
authors.initials: E
authors.lastname: Herrington
authors.forename: Vineetkumar
authors.initials: V
authors.lastname: Kharat
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Vasilakis
authors.forename: Christopher
authors.initials: C
authors.lastname: Walker
authors.forename: Cynthia
authors.initials: C
authors.lastname: Turner
authors.forename: Salma
authors.initials: S
authors.lastname: Khuwaja
authors.forename: Raouf
authors.initials: R
authors.lastname: Arafat
authors.forename: Scott C
authors.initials: SC
authors.lastname: Weaver
authors.forename: Diana
authors.initials: D
authors.lastname: Martinez
authors.forename: Cindy
authors.initials: C
authors.lastname: Kilborn
authors.forename: Rudy
authors.initials: R
authors.lastname: Bueno
authors.forename: Martin
authors.initials: M
authors.lastname: Reyna
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000914:Antibodies, Viral / Q000097:blood* / Q000134:cerebrospinal fluid; D002648:Child; D002675:Child, Preschool; D009033:Culicidae / Q000821:virology*; D003715:Dengue / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission; D003716:Dengue Virus / Q000276:immunology / Q000302:isolation & purification*; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood / Q000134:cerebrospinal fluid; D007303:Insect Vectors / Q000821:virology*; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D013781:Texas / Q000453:epidemiology; D014195:Travel; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D007075:Immunoglobulin M; D012367:RNA, Viral